Cal-D
Generic Name
Calcium Carbonate + Vitamin D3
Manufacturer
Various
Country
Global
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Description
Overview of the medicine
A combination supplement containing calcium carbonate and vitamin D3, primarily used to treat or prevent calcium and vitamin D deficiencies, and to support bone health.
Uses & Indications
Dosage
Adults
Typically 1-2 tablets daily with food, or as directed by a physician.
Elderly
Same as adults, but may require closer monitoring due to potential renal impairment.
Renal_impairment
Use with caution and adjust dose based on calcium and vitamin D levels; consult a physician.
How to Take
Take orally with water, preferably with a meal for better absorption of calcium and vitamin D.
Mechanism of Action
Calcium is an essential mineral for bone formation and maintenance. Vitamin D3 facilitates the absorption of calcium from the gut and its deposition in bones, and plays a role in calcium and phosphate homeostasis.
Pharmacokinetics
Onset
Not acutely observed for chronic supplementation. Effects on bone density develop over weeks to months.
Excretion
Calcium is primarily excreted via kidneys (urine) and GI tract (feces). Vitamin D metabolites are excreted mainly in bile and feces.
Half life
Calcium has complex pharmacokinetics; Vitamin D3 (cholecalciferol) has a half-life of approx. 24 hours, but its active metabolite calcitriol has a longer half-life (15-20 days).
Absorption
Calcium absorption varies (20-40%) and is enhanced by Vitamin D. Vitamin D3 is absorbed from the gut.
Metabolism
Calcium is not metabolized in the traditional sense. Vitamin D3 is hydroxylated in the liver (to 25-hydroxyvitamin D) and then in the kidney (to 1,25-dihydroxyvitamin D, calcitriol).
Side Effects
Contraindications
- Hypercalcemia
- Hypercalciuria
- Severe renal impairment
- Nephrolithiasis (kidney stones)
- Hypersensitivity to any component
Drug Interactions
Digoxin
Increased risk of arrhythmia in hypercalcemia.
Levothyroxine
Calcium can impair absorption; separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption; separate administration by at least 30 minutes to 2 hours.
Thiazide diuretics
May increase risk of hypercalcemia.
Tetracyclines/Fluoroquinolones
Calcium can reduce absorption; separate administration by at least 2-4 hours.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include hypercalcemia (nausea, vomiting, constipation, muscle weakness, polyuria, thirst). Management involves discontinuing the supplement, hydration, and medical supervision.
Pregnancy & Lactation
Generally considered safe and essential during pregnancy and lactation, but dose should be monitored and approved by a physician.
Side Effects
Contraindications
- Hypercalcemia
- Hypercalciuria
- Severe renal impairment
- Nephrolithiasis (kidney stones)
- Hypersensitivity to any component
Drug Interactions
Digoxin
Increased risk of arrhythmia in hypercalcemia.
Levothyroxine
Calcium can impair absorption; separate administration by at least 4 hours.
Bisphosphonates
Calcium can reduce absorption; separate administration by at least 30 minutes to 2 hours.
Thiazide diuretics
May increase risk of hypercalcemia.
Tetracyclines/Fluoroquinolones
Calcium can reduce absorption; separate administration by at least 2-4 hours.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include hypercalcemia (nausea, vomiting, constipation, muscle weakness, polyuria, thirst). Management involves discontinuing the supplement, hydration, and medical supervision.
Pregnancy & Lactation
Generally considered safe and essential during pregnancy and lactation, but dose should be monitored and approved by a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, supermarkets
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have supported the efficacy of calcium and vitamin D supplementation for bone health, osteoporosis prevention, and management of deficiencies across various populations.
Lab Monitoring
- Serum calcium levels
- Serum vitamin D (25-OH D) levels
- Renal function (creatinine, eGFR) in long-term use or renal impairment
Doctor Notes
- Assess patient's dietary intake and baseline calcium/vitamin D levels before prescribing.
- Monitor serum calcium, phosphate, and vitamin D levels periodically, especially in high-risk patients or those on long-term therapy.
- Educate patients on potential drug interactions and the importance of adherence to recommended doses to avoid adverse effects.
- Consider renal function, particularly in elderly patients or those with pre-existing kidney conditions.
Patient Guidelines
- Take as directed, preferably with meals.
- Do not exceed recommended dose.
- Inform your doctor about all other medications you are taking.
- Stay hydrated.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it's almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose.
Driving Precautions
No known effects on driving ability.
Lifestyle Advice
- Maintain a balanced diet rich in calcium and vitamin D.
- Engage in regular weight-bearing exercise for bone health.
- Ensure adequate sun exposure for natural vitamin D production.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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